Why are the alpha prefixes important for Blue Cross Blue Shield?


Quick Answer

The three-letter alphabetic prefix in the identification number of clients who are insured by Blue Cross and Blue Shield plays an important role in helping administrators confirm the eligibility of the member and deduce the type of coverage offered. The prefixes help the proper departments to direct and settle claims, making the process more efficient.

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Full Answer

Prefixes are either plan-specific or account-specific. Plan-specific prefixes identify elements of a particular insurance plan. The first two letters of these prefixes identify the type of plan under which the member is covered, such as a Blue Cross Blue Shield Plan used by residents of a specific state. The last letter identifies the type pf product within the plan, indicating, for example, preferred provider organizations.

Account-specific prefixes reveal the identity of larger national accounts of employers with offices in various states. These plans offer standardized coverage to employees, and the three-letter prefix simply identifies the company or institution that offers this coverage, such as UTS for those members under the plan offered by the University of Texas. Some insurance identification cards may not have a prefix on the ID number, which likely means that these accounts use a different filing process for dealing with claims. Members should never omit the alphabetic prefix on any forms or when calling to get information on claims.

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